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    Provider Relations Associate Analyst - Remote, United States - The Cigna Group

    The Cigna Group
    The Cigna Group Remote, United States

    4 weeks ago

    Default job background
    OTHER
    Description
    The job profile for this position is Provider Relations Associate Analyst, which is a Band 2 Senior Contributor Career Track Role.

    Excited to grow your career?

    We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

    Our people make all the difference in our success.

    The Advocate role is a non-clinical customer service position within an inbound call center that supports Evernorth Behavioral Health. Advocates are responsible for handling inbound calls from both members and providers or their office support staff regarding mental health or substance use disorder services. Advocates guide and assist the members and providers to help them work with Cigna/Evernorth more effectively and ensure first-call resolution.

    The types of calls an Advocate services may include but are not limited to: inquiries about provider referrals and access to care, eligibility, and benefits. Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call. Independent problem-solving, multitasking, and technical savvy are essential to be able to carry out the responsibilities of this role. Calls must be serviced helpfully and professionally.

    Responsibilities:

    The primary responsibility of this role is to answer inbound calls from members and providers. The work environment is structured, and the majority of the day will be spent answering these calls from a queue. Occasional outbound calls may be necessary for issues requiring follow-up. The position is considered entry-level within Evernorth.

    Within a call, an Advocate may:

    • Communicate eligibility, generate a list of provider referrals, quote benefits, or advise of authorization requirements for services
    • Write authorizations to ensure claims are paid correctly
    • Provide follow-up on issues by making outbound calls when necessary
    • Send resources to members and providers via email
    • Submit a complaint on the member's or provider's behalf
    • Independently problem-solve to ensure accurate information is given, and exceptional customer service and first-call resolution is achieved
    • Conduct an intake with members to assess for presenting concerns of risk of harm or substance use concerns

    Skills

    • Customer Service experience
    • Prior experience working in a patient-focused environment preferred
    • Ability to maintain a professional and positive image to external customers
    • Candidate must possess superb interpersonal communication skills
    • Effective listening and organizational skills, with the ability to manage multiple tasks
    • Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several proprietary systems
    • Independent problem solving skills
    • Able to excel and/or prior successful experience in a virtual team environment
    • Strong time management skills
    • Ability to type effectively and have strong PC skills

    Training

    Initial training for this position will be focused on calls for referrals, benefits, eligibility, and other support resources. Additional training may be required based on business needs.

    Training hours are Monday through Friday 8:30 AM – 5:00 PM CT.

    Work Schedule

    Once training is complete, standard shifts occur Monday through Friday 7:00 AM – 7:00 PM CT. Specific shift opportunities will be shared by the recruiter.

    Education

    Bachelor's Degree required


    If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of USD / hourly, depending on relevant factors, including experience and geographic location.

    This role is also anticipated to be eligible to participate in an annual bonus plan.

    We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.

    Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

    Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.



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